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What does denosumab treat? Denosumab is approved for the prevention of bone-related events in solid tumor bone metastases, but not for the prevention of bone-related events in patients with multiple myeloma; it is approved for use in adults or bone-mature adolescents with giant cell tumors of bone that are unresectable or where surgical resection may cause serious complications; it is approved for the treatment of hypercalcemia in malignant tumors.

Denosumab is the first approved monoclonal antibody that specifically targets RANK ligand. RANK ligand is a transmembrane or soluble protein that is necessary for osteoclasts to maintain their structure, function, and survival. Human RANKL mRNA is mainly found in bones, bone marrow and lymphoid tissues. Its main function in bones is to stimulate the differentiation and activity of osteoclasts and inhibit the apoptosis of osteoclasts. Osteoclasts are responsible for bone resorption, and osteoclast precursors must have low levels of macrophage colony-stimulating factor and RANKL during their differentiation into mature osteoclasts. This product has a high affinity with RANKL, preventing RANK ligand from activating RANK on the surface of osteoclasts, inhibiting osteoclast activation and development, reducing bone resorption, increasing bone density and bone strength of both cortical bone and trabecular bone, promoting bone reconstruction, and reducing the incidence of vertebral, non-vertebral and hip fractures in postmenopausal women with osteoporosis.

Denosumab can only be given by subcutaneous injection, not by intravenous infusion, intramuscular infusion or intradermal injection. Bone metastases from solid tumors: 120 mg subcutaneously in the upper arm, thigh, or abdomen every 4 weeks. Giant cell tumor of bone: 120 mg subcutaneously every 4 weeks, followed by 120 mg on days 8 and 15 during the first month of treatment. Administer calcium and vitamin D appropriately to prevent hypocalcemia. Malignant hypercalcemia: 120 mg subcutaneously every 4 weeks, followed by 120 mg on days 8 and 15 during the first month of treatment. The medication is injected under the skin in the upper arm, thigh, or abdomen.